Response to bronchodilators in clinically stable 1-year-old patients with bronchopulmonary dysplasia.
Bronchodilators are often used in the treatment of patients with bronchopulmonary dysplasia (BPD). However, few studies evaluate their efficacy in patients with stable disease beyond the newborn period. Therefore, pulmonary function was measured before and after aerosol treatment with salbutamol (0.25 ml Ventolin 0.5%) and subsequently after aerosol with ipratropium bromide (0.25 ml Atrovent 0.025%). Studies were performed at the corrected postnatal age of 52 +/- 2 weeks in 52 patients who had been ventilated after birth because of newborn lung disease. Twenty-two of these 52 patients had developed BPD. Pulmonary function was measured after sedation and using the PEDS system. Expiratory resistance (median 52.1 versus 39.1 cmH2O/l/s; P < .008) and inspiratory resistance (median 42.5 vs 27.8 cmH2O/l/s; P < .04) were significantly worse in BPD patients at the age of 1 year. Half of the BPD patients had a decrease in pulmonary resistance after salbutamol. However, there was no statistically significant decrease in pulmonary resistance after salbutamol or ipratropium in the BPD patients as a group. After salbutamol pulmonary resistance significantly worsened in the patients who did not develop BPD.


CONCLUSIONS
Although individual patients may benefit, routine administration of bronchodilators seems not warranted in stable BPD patients at the age of 1 year.
De Boeck
K
K
University Hospital Gasthuisberg, Department of Pediatrics, Leuven, Belgium.
Smith
J
J
Van Lierde
S
S
Devlieger
H
H
D000280:Administration, Inhalation; D000403:Airway Resistance / Q000187:drug effects; D000420:Albuterol / Q000008:administration & dosage*; D001993:Bronchodilator Agents / Q000008:administration & dosage*; D001997:Bronchopulmonary Dysplasia / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D016009:Chi-Square Distribution; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D009241:Ipratropium / Q000008:administration & dosage*; D011379:Prognosis; D012129:Respiratory Function Tests; D016896:Treatment Outcome
D001993:Bronchodilator Agents; D009241:Ipratropium; D000420:Albuterol